Your letters: September 15, 2009

The transgressions of California Assemblyman Mike Duvall, which led to his resignation last week, reinforce the cynicism that many of us feel about our elected leaders, regardless of their political party. Mr. Duvall’s actions failed the people of his district and the state in three separate ways.

First, he failed his wife and family by cheating with at least two lovers in Sacramento. Don’t these guys read the papers? You would think elected officials would learn something after watching other politicians ruin their careers and families with their selfish behavior.

Second, he showed incredible contempt for basic ethics by sleeping with a lobbyist who brought matters before his committee. Aren’t we all incredibly tired of elected officials utterly ignoring ethics? I think we should pass a law that every legislator from both parties must take a lie-detector test annually to see if they are taking sexual favors or anything else inappropriate from lobbyists.

Third, Mr. Duvall is guilty of gross hypocrisy by proudly proclaiming his 100 percent family values voting record while living a life that mocks common decency. Add it up — moral lapses, ethical contempt and hypocritical lifestyle. This is the triple crown of personal failure. And for a bonus, he was boorish enough to brag about his escapades in front of a microphone.

— David Maron, Camarillo

Disgraceful legislators

We send our elected officials to Sacramento to balance California’s budget, fix our roads, keep us safe and make sure the state has water. They get more than $160,000 a year, a state automobile and $173 per diem while in session. The first things they do are hire interns and mingle with lobbyists with whom they party and have affairs. They set up slush funds so they can travel the world in style and buy nice things for those interns and lobbyists. Then they reward the lobbyists by voting the “right” way. They don’t even come close to doing their job. Is this the best we can do? How long are we going to stand for this?

The corruption and incompetence are unacceptable! The full-time Legislature experiment in California is a failure. We must go back to a part-time Legislature like successful states such as Texas have. Our so-called leaders are a disgrace to this state.

As an experienced nurse with a graduate degree in prenatal and perinatal psychology, I feel compelled to address this article that depicts the overmedicalization of birth in our culture today.

The World Health Organization guidelines state that the Caesarean section rate should be no more than 10 to 15 percent of all births, and it is known that rates above that seem to do more harm than good. Yet, in the United States today, the Caesarean section rate is over 30 percent, twice that of 1996, and continues to rise, with some hospitals as high as 50 percent.

The reasons for this are many and controversial but mostly stem from the fact that parents are not made aware of the evidence-based research that shows that birth interventions do more harm than good. This creates an environment that places low-risk pregnancies with less-than-optimal outcomes for mothers and babies.

While childbirth is a natural human biological process, it is the leading cause for hospitalization in the United States today. The current trend for childbirth care is highly technical and contributes to almost half of the most commonly performed hospital procedures for the entire population, including C-sections and labor inductions.

These procedures add greatly to our rising healthcare costs and, in this era of healthcare reform, should be a focus issue.

It seems that many of the parents mentioned in this article who chose these technical means to have their babies born on 09-09-09 did so because they believe it is a symbol of “good luck.” I am overjoyed that all of those babies are “doing well.” Yet, I am concerned that, if the facts were really known about the overmedicalization of birth in this country today, many would consider more holistic means to bring to bring their babies into a more natural, caring and loving environment.

— Mary Anne Vernallis-Strohsahl, Newbury Park

Facts are complicated

Re: Frank Bland’s Sept. 13 commentary, “Just the facts, please”:

As a registered nurse with a certification in case management, I may be able to shed some light.

The government does not negotiate with hospitals. Each diagnosis is “weighted,” or given a certain dollar amount. Medicare pays hospitals for a patient admission, not on a daily basis, but pays the hospital based on the diagnosis. For example, if the diagnosis is pneumonia, the reimbursement may be $3,000 (hypothetical), regardless if the patient was in the hospital for one day or 20 days. Based on this type of reimbursement, hospitals are not able to project what the reimbursement would be on a daily basis.

The determination of the dollar amount is called Diagnostic Related Group, or DRG. The criteria for each diagnosis have been determined by a panel of physicians expert in their field.

On the other hand, most insurance companies, as well as Medi-Cal, negotiate a daily rate with hospitals, and the reimbursement is individual to the agreed rate between the hospital and the insurance company. Other insurances reimburse 70 to 80 percent of the charges.

So, if all insurances paid at 70 to 80 percent, a bill of $55,000 would have netted significantly more than a daily agreed upon rate, or a DRG reimbursement.

Yes, there are many factors hospitals need not to profit, but to meet the bills. The salaries of not only nurses, but social workers, dietary workers, janitors, security, transportation orderlies, administration, radiology technicians, laboratory personnel, medical staff personnel, respiratory therapists, staffing and other secretaries, pharmacy personnel, switchboard operators, engineers, admitting and emergency personnel, plus care of uninsured patients, not to mention maintenance of the physical plant, are all part of the costs of the hospitals. These costs do not end at 5 p.m., as in most other industries, but require 24-hour services.